A recent clinic trial is expanding the evidence base for the Wobenzym^® brand. The results are published in Therapeutic Advances in Musculoskeletal Disease. The trial evaluated the effects of peri-operative use of an oral enzyme combination (OEC) with bromelain, trypsin and the flavonoid rutoside in patients undergoing elective total hip replacement (THRs).

The trial found that compared with the placebo group, the OEC group had significantly lower blood C-reactive protein levels (a marker of inflammatory activity in the blood) during the acute post-operative phase, the first seven days after THR. Patients in the OEC group also reported significantly less post-operative pain than those in the control group during this early phase of recovery from surgery. OEC was well tolerated and showed an overall safety profile similar to the placebo.

THRs are one of the most common types of surgery in the western world and are performed increasingly frequently due to consequences of osteoarthritis. Patients are strongly encouraged to become mobile as soon as possible after surgery but they are often limited by post-operative pain. This is complicated by fact that the broad use of multimodal analgesics such as NSAIDs is somewhat restricted due to potential undesirable side effects shortly after surgery.

The clinical study comprised 33 patients eligible for primary elective cementless THR due to osteoarthritis. They were recruited from a tertiary orthopaedic hospital in the Czech Republic. Eligible individuals were randomised to either OEC or placebo and followed for 42 days after surgery.

This is the first randomized and placebo-controlled clinical study exploring OEC effects in people with long-term complications of hip osteoarthritis scheduled for THR. Results indicate that OEC has the potential to significantly reduce blood (systemic) inflammation and to alleviate patient self-reported pain already within the first week after surgery. This suggests that OEC could be an attractive treatment option to improve post-operative THR recovery and to facilitate early mobilization after surgery.

Oral enzyme combination with bromelain, trypsin and the flavonoid rutoside reduces systemic inflammation and pain when used pre- and post-operatively in elective total hip replacement: a randomized exploratory placebo-controlled trial